Temporal Trends in Cardiovascular Hospital Discharges Following a Mass Chlorine Exposure Event in Graniteville, South Carolina.

摘要: Background: On January 6, 2005, a train derailed in Graniteville, South Carolina, releasing nearly 60,000 kg of toxic chlorine gas. The disaster left nine people dead and was responsible for hundreds hospitalizations outpatient visits the subsequent weeks. While gas primarily affects respiratory tract, growing body evidence suggests that acute exposure may also cause vascular injury cardiac toxicity. Here, we describe incidence cardiovascular among residents zip codes most affected by plume, compare discharges years leading up to event (2000-2004) following (2005-2014). Methods: De-identified hospital discharge information collected from Carolina Revenue Fiscal Affairs Office individuals residing selected 2000 2014. A quasi-experimental study design utilized with population-level interrupted time series model examine rates Graniteville-area three diagnoses: hypertension (HTN), myocardial infarction (AMI), coronary heart disease (CHD). We used linear regression autoregressive error correction slopes pre- post-spill periods. Results: significant increase hypertension-related observed Graniteville spill (slope 8.2, p<0.001). Concurrent changes CHD AMI were opposite direction (slopes -3.2 -0.3, p<0.01 0.14, respectively). Conclusions: An unusual area contrasts national state-level trends. number factors related be contributing observation: disaster-induced hypertension, healthcare services access issues, and, possibly, chlorine-induced susceptibility pathologies. Due limitations our data, cannot determine whether who visited ones exposed gas, however, finding warrants future research etiology are at heightened risk hypertensive disease.